J Korean Soc Emerg Med.  2006 Oct;17(5):438-446.

Initial Prognosis Predictors of Functional Recovery in Acute Ischemic Stroke

Affiliations
  • 1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. bjoh@amc.seoul.kr
  • 2Department of Emergency Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea.

Abstract

PURPOSE: Emergency physicians are often asked to predict a patient's functional outcome after an acute stroke. However, very little information is usually available to a physician to help predict the likelihood of severe permanent disability. The purpose of this study was to determine useful Initial prognostic predictors in patients with an acute stroke presenting to the emergency department.
METHODS
Between March 1, 2004 and May 31, 2004, we analyzed 74 patients diagnosed to have an acute stroke by diffusion weighted magnetic resonance imaging obtained within 24 hours from symptom onset at the emergency department. Seven factors were evaluated as prospective variables including The National Institutes of Health Stroke Scale (NIHSS) measured by emergency physician (NIHSSEM) and neurologist (NIHSS-NR) at the time of presentation to the emergency department. The outcome variables were Barthel Index (BI), modified Rankin Scale (mRS), and the NIHSS measured at the time of discharge from hospital.
RESULTS
The intraclass correlation coefficient between NIHSS-EM and NIHSS-NR was 0.94 (p < 0.001). History of stroke, gender, NIHSS-EM, large vessel disease and lacuna infarctions were statistically significant outcome predictors. In a multivariate logistic regression analyses, NIHSSEM was the only independent variable that correlated with NIHSS, mRS, and BI at hospital discharge.
CONCLUSION
Among the many prognostic predictors studied, the NIHSS appeared to be the only independent variable showing a correlation with the patients's prognosis. The NIHSS perfomed in the emergency department may help emergency physicians provide more accurate initial prognosis in an acute stroke patient.

Keyword

Cerebrovascular accident; Acute; Prognosis

MeSH Terms

Diffusion
Emergencies
Emergency Service, Hospital
Humans
Infarction
Logistic Models
Magnetic Resonance Imaging
National Institutes of Health (U.S.)
Prognosis*
Prospective Studies
Stroke*
Full Text Links
  • JKSEM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr